Shattered Dreams and Reasonable Hope: Essential Links. Overview of Session

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com Overview of Session Change and transition Shattered dreams,

1 Shattered Dreams and Reasonable Hope: Essential Links Overview of Session Change and transition Shattered dreams, especially for elders Chronic sorrow a developmental perspective Responses to losses Reasonable hope Discussion throughout 1

The Guest House This being human is a guesthouse.

Beginning lines of a poem by Rumi Storying And Restorying After Loss Involves

2 The Guest House This being human is a guesthouse. Every morning is new arrival. A joy, a depression, a meanness, some momentary awareness comes as an unexpected visitor. Welcome and entertain them all! Beginning lines of a poem by Rumi Storying And Restorying After Loss Involves Grieving The Old Story Before Creating The Next (Not Necessarily New) Story ---- Listen For Major Components/Themes/Values Of The Old Story How Can They Be Reframed In The Next Story 2

Reminiscence and Life Review Reminiscence is the act or process of recalling the remote past in a silent, spoken, solitary, interactional, spontaneous, or structured way.

3 Reminiscence and Life Review Reminiscence is the act or process of recalling the remote past in a silent, spoken, solitary, interactional, spontaneous, or structured way. Life review is a more formal and more intense intervention. Life review is the process of reviewing, organizing and evaluating the overall picture of one's life with the purpose of achieving integrity by seeing one's life as a unique story. Both reminiscence and life review use memory and recall in their processes. Change Change Change Is A Time When Predictability Breaks Down Our Predictable Ways Of Thinking About And Doing Things Are Interrupted By Change Change Results In Uncertainty 3

4 For Everyone Change is a Challenge For Some Change is a Welcome Opportunity For Some Change is a Threat For Some Change is Taken in Stride For Some Change is One More Too Many Be Respectful With Those With Different Responses Change And Transition It isn t the changes that do you in, it s the transitions. Change is not the same as transition. Change is situational: the new technology, the new procedure, the new worker, the new challenge. Transition is the psychological process people go through to come to terms with the new situation. Change is external, transition is internal. adapted from William Bridges 4

5 Clarifying Change and Transition Change is a situational shift: Getting a new hip is a change, and so is receiving an unexpected, positive gift or losing your job; Moving to a different home is a change, and so is remodeling your house or losing it in a fire; Having or welcoming a new grandchild is a change for everyone in the family And, of course, losing a loved one is a change a huge one. Transition is the process of letting go of the way things used to be and taking hold of the way they subsequently become Transition is the way we all come to terms with change. Wm. Bridges Transition Starts With an Ending The starting point for transition is not the outcome but the ending that you will have to make to leave the old situation behind. Situational change hinges on the new thing, but psychological transition depends on letting go of the old reality and old identity you had before the change took place. Wm. Bridges Managing Transitions 5

6 Examples of Loss: Transition Needed A sudden and unexpected event that destroys the old life that made one feel like oneself The drying up of a situation or relationship that once felt vital and alive An activity that has always gone well before, suddenly and unexpectedly goes badly A person or organization you trusted proves to be untrustworthy An inexplicable or unforeseen problem crops up at the worst possible moment, to disrupt ordinary functioning Loss Refers to being deprived of or ceasing to have something that one formerly possessed or to which one was attached Grief A whole body response to loss: emotional, cognitive, spiritual, visceral 6

7 Things That Affect The Experience Of Loss Nature Of Attachment Mode Of Separation (Voluntary or not, Crisis, Illness) Personality Variables, Including Tolerance For Change History Of Losses Social Variables Life-change Events Shattered Dreams Based On Work Of Wm. Worden Factors Which Exacerbate Losses Loss Or Stress Accumulation/Overload Loss Of Control Or Power Losses Which Break Normative Rules Losses Which Violate "Moral" Expectations Losses That Stretch Developmental Abilities Losses Which Reinforce Or Precipitate Family Conflict Disenfranchised Losses Losses Which Continue To Require Adjustment After Onset Ambiguous Losses Loss Of Dreams 7

Loss as a Broad Concept Six Major Types (Mitchell and Anderson/Bowman) Material Losses Relationship Losses Health Losses Role Losses Systems Losses Loss of Dreams Disenfranchised Grief

8 Loss as a Broad Concept Six Major Types (Mitchell and Anderson/Bowman) Material Losses Relationship Losses Health Losses Role Losses Systems Losses Loss of Dreams Disenfranchised Grief (Doka, 2002) Griever, relationship, and loss itself Grief in Later Life Rapidity of Losses Finality of Losses The Ever-present Character of Loss Losses are Cumulative R. Scott Sullender 8

Dehumanization of Loss Repeated experiences of unacknowledged and unmourned loss contribute to the dehumanization of loss It s one thing to lose something that was important to you, but it is far

9 Dehumanization of Loss Repeated experiences of unacknowledged and unmourned loss contribute to the dehumanization of loss It s one thing to lose something that was important to you, but it is far worse when no one in your universe recognizes that you lost it. The failure to acknowledge another s loss is to deny that person s humanity. KEN HARDY Differences: Chronic Sorrow and Complicated Grief Both contain sorrow that can be ongoing Both contain elements of depressive emotions and experience The Key Difference Is The Ability To Grow Life, Experience Joy And Fullness Regularly, Even While Also Grieving 9

10 Responses To Loss Name Losses Grieve Losses Put The Loss In Perspective Reinforce Or Build Support Connections Set Limits (Saying No To Some Things So You Can Yes To Others) Develop A Healing Plan Use Rituals For Grieving And Healing 10

11 Metaphors of Loss / Grieving grief never leaves only changes, it waits outside doors keep a place at the table Susan Williams One morning, cereal. The next day, cancer. Richard Solly disaster sucks all the air from the room, swings shut doors in our brains corridors Heid Erdrich All I have is a broken voice Wang Ping Kopp Framework Follow Metaphors 1) Notice metaphors 2) Invite the client to explore 3) If I were seeing it the way you see it, what would I see? 4) Practice curiosity 5) Describe feelings associated with the metaphor 6) Invite transformation 7) What if the metaphor were a.? 8) Connect metaphor and life issues 11

Shattered Dreams Losing An Emotionally Important Image Of Oneself, One's Family, One's Life, One s Work, Even One s Death Losing The Possibilities Of "What Might Have Been" Abandonment Of Plans For A

12 Shattered Dreams Losing An Emotionally Important Image Of Oneself, One's Family, One's Life, One s Work, Even One s Death Losing The Possibilities Of "What Might Have Been" Abandonment Of Plans For A Particular Future The Dying Of A Dream Assumptive World All of us from the moment of our birth, have been building inside ourselves a model of the world, a set of assumptions on the basis of which we recognize the world that we meet and plan our behaviour accordingly. Because this model is based on reality it is, most of the time, a valid and useful basis for thought and behaviour. We rely on the accuracy of these assumptions to maintain our orientation in the world and to control our lives. Anything which challenges this model incapacitates us. C.M.PARKES 12

13 Shattered Dreams and Aging: Examples the dream of retirement the dream about how or where a home "should be" the dream of time for self (autonomy/control the dream of family privacy the dream that the family relationship could withstand any stress or challenge the American dream of "social security the dream that plans would be sufficient...or things will work out when we get there the dream of dying and death Shattered Dreams / Bereavement The dream of death how, where, when, who The dream of the funeral The dream of dying The dream of retirement, travel, marriage, travel, expectation unfulfilled The dream of being touched The dream of an uncomplicated death The dream of never being alone 13

14 Variations of Shattered Dreams Hindsight Dreams dreams not known then, but known now Interrupted/Postponed Dreams Dreams Denied Dreams Ended Missed Dreams opportunities passed, now too late Stolen Dreams because of lif circumstances Failure to Dream Frozen Dreams dreams still held in spite of changes Cue Words Shattered Dreams I didn t expect this... I feel hopeless! Why did I even bother...? I thought it would... It doesn t matter... If only I don t care any more I never imagined this I can t live the way I am Will I ever...? You decide... You don t understand 14

15 Inquiries about Shattered Dreams When you pictured this time in your life, what did you picture? When you thought about being, what did you picture? If and when you thought of losses in your family, how did you think it would be, how would it happen? Tell me about the plans you and (the name of the person had? 15

16 Ambiguous Loss Losses that are: unclear, confusing, and for which future stories / outcomes are unknown Etymology: driven in both ways Boss Ambiguous Loss: Conundrum Psychological Presence And Physical Absence Physical Presence And Psychological Absence 16

Ambiguous loss is inherently traumatic because the inability to resolve the situation causes pain, confusion, shock, distress, and often immobilization.

17 Ambiguous loss is inherently traumatic because the inability to resolve the situation causes pain, confusion, shock, distress, and often immobilization. Without clarity/closure the trauma of this unique kind of loss becomes chronic. Responses to Ambiguity Label what people are experiencing (responses will vary) Provide a structure and setting for contact Provide information Increase tolerance for ambiguity Be flexible, adapt routines, minimize helplessness, normalize situation Emphasize what can be changed or addressed and what can not Move from either/or choices to both/and choices 17

18 Two Principles If Something Is Unmentionable, It Is Also Unmanageable FOLK WISDOM Not Everything That Is Faced Can Be Changed, But Nothing Can Be Changed Until It Is Faced James Baldwin What Helps? It Is Those Who, Instead Of Giving Advice, Solutions Or Cures, Acknowledge The Pain And Touch Our Wounds With A Gentle And Tender Hand Someone Who Can Be Silent In A Moment Of Despair Or Confusion Who Can Tolerate, Not Knowing, Not Curing, Not Healing And Face With Us Our Loss OKUN AND RAPPAPORT / NOUWEN 18

37 Dual-processing model (Stroebe and Schut 2001) Loss Orientation Grief work Intrusion of grief Denial and avoidance of restoration changes Restoration Orientation Attending to life changes Doing

19 37 Dual-processing model (Stroebe and Schut 2001) Loss Orientation Grief work Intrusion of grief Denial and avoidance of restoration changes Restoration Orientation Attending to life changes Doing new things Distraction, denial, avoidance of grief New roles, identities, relationships Hope Definitions usually include: EXPECTATION DESIRE Which can involve GOALS, ATTRIBUTES, REDEFINITION, MEANING, PEACE, ENERGY 19

20 Reasonable Hope: Characteristics Reasonable hope is relational Reasonable hope is a practice Reasonable hope maintains that the future is open, uncertain, and influenceable Reasonable hope seeks goals and pathways to them Reasonable hope accommodates doubt, contradictions, and despair Weingarten Hope includes a future story. Hope includes a shared story. Hope includes stories of meaning. Hope includes an affirmative story. Hope includes the real story. 20

21 I have only one small grain of hope I need more I break off a fragment to send you Please take this grain of hope So mine won t shrink Please share your fragment So that yours will grow Only so, by division, Will hope increase Denise Levertov 21

The Ongoing Losses When Living with Dementia. Ted Bowman Family and Grief Educator

The Ongoing Losses When Living with Dementia Ted Bowman Family and Grief Educator www.bowmanted.com tedbowman71@gmail.com Overview of Content Self-awareness essential starting point Stories of dementia